"But What Woman Could They Serve?" - Lisa Barrett On Eligibility

Lisa Barrett has shared an update about the eligibility criteria midwives face with the new reforms coming into force July 1st. She highlights that important questions (such as "what will so-called collaboration entail?') remain unanswered.

I believe Lisa says it best when she says:

"I’m sure there are midwives that will jump high enough to become eligible but what woman could they serve?"

These reforms really are a big step away from normal physiological childbirth options in Australia. Presently the easiest, most supportive and most certain way of achieving a vaginal birth after caesarean, a vaginal breech birth, a vaginal twin birth, an intervention free normal physiological birth etc is to stay at home in the care of an independent midwife. Women who do achieve such things in the hospital system do so against great obstacles and a lot of their birthing energy gets diverted towards fending for their rights. When being an eligible and collaborative midwife means not taking on women who fall into the aforementioned categories, what will become of those birth options and of those women? Either these women will be cajoled into submitting to unnecessary surgery (and the significant risks inherent to it) or they will be left with no other option than to go it alone or seek underground midwifery care (which puts themselves and the midwives they hire in danger in terms of State regulation and the law).

As I've been saying since talk of these reforms first began: they mark yet another nail in the coffin for normal physiological birth in Australia.

International Midwives Day: Melbourne Event

The following is from an email I recieved from a Maternity Coalition email list:

"Maternity Coalition Victoria is hosting a morning tea to celebrate International Midwives Day on 5 May 2010.

Please join us at the Royal Botanic Gardens, Melbourne from 11am to 12:30pm. We will be on the Western Lawn near the Children's Garden (enter through the Observatory Gate).

Everyone is welcome. Please forward this invite on to anyone you know who might be interested.

You can find details of the event on Maternity Coalition Victoria's new Facebook page"

The Facebook event page includes a picture with text stating "The world needs midwives now more than ever", so very true!

Your Government, Removing Documents As Fast As Rights

Lisa Barrett has published another update about the future of homebirth midwifery in Australia. Lisa has seen the behind the scenes documents our government has written about plans for the future of our maternity services. Outlook bleak. To read her reflections:

Quality and Safety Framework For Eligibility

Government Insurance For Midwives (Snigger)

The Department of Health and Aging published a document entitled "Indemnity insurance - protection for midwives" outlining their plans for the future of midwifery. Within a matter of hours the site disappeared. Luckily Ms Barrett downloaded the original and has shared a copy on her blog:

Indemnity Insurance PDF

It will be very interesting to see what the new version looks like whenever it may appear. In the meantime I had a cynical little giggle to the following image a friend shared on her Facebook profile:

"Doula!" Forthcoming Documentary

Due in June. Here are some previews:

To see the film's website go to: http://doulafilm.com/

Cycling For Women, Our Boobs & Babes

On Saturday April 24 Northern Territory midwife Marg Phelan sets off on a year long bike ride around Australia for women, babies, birth and breastfeeding. According to the endeavours' webpage:

"Marg Phelan is combining her life's passions to spread the word that women have a right to choose where and with whom they give birth, and to be properly supported in these choices.

Marg's aim is to educate Australian women of all ages, locations, lifestyles and circumstances about the benefits of care from a known and trusted midwife and the importance of good support"

The site also states: "Go Girl Australia is a not-for-profit venture that aims to promote continuity of care from a known midwife, normal birth and breastfeeding."

For more information check out Go Girl's website and find out about sponsorship opportunities.

See also: Darwin Homebirth Group.

A Glimmer Of Hope? Or Dust In My Eye?

After my update about the homebirth situation two of our independent midwives have posted updates of their own.

From Lisa Barrett:

"If at all possible most midwives will jump through the hoops to continue on the register, rendering it almost impossible, even with a right of refusal, for her to support the women who don't want to collaborate with the hospital, or put in place a plan for transfer that includes more than calling an ambulance and ringing the hospital in advance of arriving." (Read in full here)

Joy Johnston From Private Midwifery Services:

"We know that we will be required to have professional indemnity insurance that covers everything we do professionally, excluding homebirth.
What we don't know yet includes: Who will provide the indemnity insurance? What that insurance will cost? What 'excluding homebirth' means, precisely. When does homebirth begin and end, for the purposes of this insurance? What will we be required to do to access the exclusion for homebirth?...

As far as I know, insurance brokers who are looking into providing this special insurance product for midwives' private practices have not yet put any offers on the table publicly. The Australian College of Midwives has informed members that it has a product which will be available for a fee in addition to membership fees. The Australian Nursing Federation (Victorian Branch) has informed members that it is also negotiating a product suitable for members who are independent midwives." (Read in full here)

The other day a friend of mine posted the following quote on his Facebook wall and it gave me a little glimmer of hope:

"Every major movement for social change in our history was hopeless. Hopeless from the beginning, hopeless through the middle, hopeless up to the very end. But then, like a bolt out of a blue sky, a breakthrough. So our job is not to give up, give in or go away. Take action, speak clearly as you can, & trust the lesson of history: Truthful, nonviolent movements are destined to win." John Dear on Howard Zinn"

I know that homebirth will continue in Australia after July 1. If I really want to see a plus side in this entire ordeal I suppose I could say "look at all the publicity homebirth has received in the last year!" Getting the word out there that homebirth is an option has always been a bit of a struggle in medico-addicted-Australia, but in the last year average Australians have been exposed to the idea through the mainstream media (albeit not a great deal, but more than before these reforms began). Parties involved in regulating maternity services, politicians, journalists etc have been forced to see the diversity of homebirthing families. And I'm optimistic that the forthcoming Face of Birth documentary about homebirth in Australia will do us all a great service.

With Lisa and Joy I sit and wait to see what the next chapter has in store for us all...

"Face Of Birth" Aussie Birth Documentary

I'm really excited to share the following teaser for a documentary about maternity services in Australia. It looks as thought this doco focuses on homebirth and what the future of homebirth in Australia might be.

The film's website provides the following outline:

"In the Netherlands, one woman in three chooses to birth at home. In Australia this option is about to become unlawful… The Face of Birth is a one-hour documentary that seeks to examine the political, the professional and the personal stories behind what is at stake for women and their babies, and whether or not we all should care."

There's footage from last years' national rally and a really great sample of articulate homebirthing women speaking their truth:

I really loved Midwife Jan Ireland's comment:
"We don't lose many babies in Austrlaia, we're very lucky because we've got good nutrition, good social circumstances. But what we do lose are a lot of marriages, and a lot of relationships, and a lot of people's mental health after childbirth."

To find out more about the documentary check out the website: http://faceofbirth.com

Update On The Future Of Australian Homebirth

On March 16 The Senate passed the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009. While the health minister has been keen to highlight that these reforms mean Australian women will supposedly be able to choose their own midwife for pregnancy, birth and postpartum care for a birth centre or hospital birth (thereby fostering continuity of care) and that midwives will have access to medicare, we still lack a clear definition of the terms "collaboration" and "eligible midwife" as used in the Bill.

It is still unclear whether "collaboration" means doctors and independent midwives working on an equal footing or doctors having the power of veto over midwives (and the women who hire them). For those of us familiar with the workings of the current maternity system it is hard not to assume a cynical definition of "collaboration". As stated on the Private Midwifery Services blog:

"Even today, before any of these reforms come into effect, some doctors refuse to provide services, such as ordering blood tests, if they know a woman is planning homebirth attended by a private midwife. Women have been told by their GPs that the GP is not willing to accept the 'risk', from an indemnity point of view, of collaboration with a midwife. Midwives who try to make collaborative arrangements with local hospitals, establishing transparent and seamless processes for referral and transfer to hospital care when appropriate often face barriers and difficulties."

This does not fill homebirthers and independent midwives with much hope.

In Birth Writes (newsletter of the Victorian Branch of Maternity Coalition) Joanne Smethurst notes that "There is nothing in the Bills for homebirth – the Bills neither support nor outlaw homebirth." (April 2010: 2). She goes on to state that the health minister has assured homebirth lobbyists that midwife attended homebirth will remain an option for Australians, but just how easy that access will be remains unclear. Melbourne private practice midwife Joy Johnston said it best when she wrote on her blog:

"It's POSSIBLY a landmark day for SOME midwifery. But for midwives like me, who have chosen to be employed privately by women for homebirth or for other private midwifery services, the legislation gives us little to cheer about. Even the promise of Medicare and prescribing rights, to be implemented by November this year, appears to be so wound up in bureaucratic micro-management that we wonder if we will ever be able to meet the criteria. We are doubtful that the Medicare-funded midwife will be able to provide any service that is acceptable to clients, at the same time as providing a reasonable livelihood for the midwife."

To attempt to have your say (yet again) there is the option of sending your feedback to The draft National Guidance on Collaborative Maternity Care. This remains open to public consultation until April 27th.

You mean we have to write to the government AGAIN?!

For more information:

A Landmark Day For Midwifery in Australia?

Maternity Coalition's 101 on The Passed Bills

Questions About Professional Indemnity Insurance For Midwives

Maternity Coalition's Q&A on Maternity Reform

Maternity Coalition's 10 Steps to Keeping Maternity Reform on Track

Scope of Practice - Questions Raised By One Midwife in Private Practice

What The Government Says About These Maternity Reforms

Peninsula Birth Support April Meet: Prenatal Testing

Got a story to share about your experiences with prenatal testing? Interested in learning more about what tests are offered during pregnancy? Why not come to picturesque Frankston to hear what Eastside Midwives: Andrea, Helen and Karen have to say?

For more information see Peninsula Birth Support's blog: http://mcpeninsula.blogspot.com